Obviously, accidents are, well, accidental, but if we purposefully avoid identifying relative responsibility, then we risk putting ourselves and others through them again. After all, if we don’t take responsibility for accidents that are not largely accidental, we miss an opportunity to prevent them. And if we do take responsibility for accidents that are entirely accidental, we compound the misery unnecessarily, which may make more accidents happen. So, instead of getting swept up in shame or guilt, add up the facts and seek second opinions. Accidents happen, but if you don’t learn from them you’re deliberately setting yourself up for more mistakes.
–Dr. Lastname

My sister drinks because she says it’s the only way to make her anxiety go away—her anti-depressants don’t do it—but she’s been hospitalized three times now because of blackouts caused by drinking and taking extra medication. She gets mad when they try to keep her at the hospital for observation because she always says that she didn’t want to kill herself, she was just trying to get some relief for depression and screwed up by drinking, and being at the hospital makes her more depressed and then she signs out as quickly as possible. She’s mad at me and the rest of the family for insisting that she has a problem with alcohol and needs help, because she thinks we’re just freaking out over a few stupid mistakes and we’re doing this because we like to make her feel worse. My goal is to find her the help she needs.

As you already know, the only problem your sister will admit to having is the one she has with you and your insane overreacting, and maybe also one with your family, who should love her the most but are making her difficult life even more excruciating. You almost can’t blame her for turning to the bottle.

What’s hard for you to accept, of course, is that you can’t get through because, from what you’ve described, her mind is focused entirely on the way she feels in the moment, and in most moments, it’s lousy.

She might have even felt suicidal at the time she almost died, but since she doesn’t afterwards, what was a suicide attempt is now, in her estimation, a silly mistake. As such, she’s not lying, she’s just incapable of seeing the big picture. Shrinks call people whose depressed and angry feelings distort things this way “borderline personality disorders” and, when their distortion is as severe are your sister’s, there’s nothing much that can help them, at least not for the time being.

So don’t try to argue or tell her how much she needs help. Instead, simply trust yourself and act according to what you see and believe. You can’t promise her that she’ll feel better if she stops drinking, particularly not at first. You can promise her, however, that treatment and sobriety can help her think more positively, act more carefully, and reduce the risk of accidental overdose and death if she truly wishes to build a better life.

Instead of letting the close call that led to her hospital admission make you feel responsible for finding a solution, use her hospitalization as evidence that you’re right about her need to take better care of herself. Don’t argue with the fact that the hospital is scary, she feels worse, and treatment will probably not help her. What will help her, you’re sure, is for her to take the lead in figuring out how to prevent this from happening again.

Don’t make yourself responsible for saving your sister, and don’t make her responsible for being more self-aware than her brain can handle. If you can offer her a vision of sobriety, self-control, and safety that you believe will help her, then you’ll stop being her “problem” and start being her map to a solution.

STATEMENT:
“I can’t stand to watch my sister destroy herself, but I know I have no power to stop her. I will not let frustration, anger, or guilt stop me from urging her to choose a better way, knowing it’s very hard for her to see it.”

Just as I was starting to manage my OCD, my insurance company got my name confused with someone else and stopped paying my doctor and therapist. Now they’re both upset, my OCD has come back full force and I can barely function or go to work. I feel terrible in every way possible. My goal is to figure out how to get my doctors paid so that they can forgive me and I can get them out of this mess.

OCD may help you when it’s time to solve difficult problems that need lots of thought, but it tends to give you a one-track mind. Whatever you think about, that’s what’s most important. It’s hard for you to think about two things at once, compare them, and decide which is more important. It makes sense that you’d feel terrible, but focusing on how your doctors must feel terrible isn’t going to help anyone.

What has captured your attention, obviously, is your doctors’ distress at running into an insurance glitch; you instantly feel responsible. That’s nice of you, perhaps, from the doctor’s point of view, but it’s hardly fair to you, your needs, and the responsibility you should properly assign yourself.

As long as you feel responsible for their distress, you can’t help but feel totally helpless, because you’re not an insurance company and can’t be sure that the glitch will be solved. If you step back, however, and ask yourself how much responsibility is properly yours, you won’t have nearly as much to worry about.

Yes, it’s your job to make calls, assert yourself, and, if it doesn’t work, look for ever-higher authorities to speak to, both inside the insurance company and among its regulators, like state government. At the same time, it’s also your job to assure yourself that, by doing so, you’ve met your responsibilities and that life has never been under your control. Meanwhile, if the doctors are distressed, they can go see a doctor themselves.

STATEMENT:
“I get worried when I see my doctors, whom I rely on to calm me down, get upset. I know, however, that I’ve managed my responsibilities well and that it’s not my job to worry too much about their feelings. If I work on this billing problem, I will probably be able to solve it.”